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Comment on: Five-year long-term outcomes of intrastromal corneal ring segment implantation using the manual technique. J Cataract Refract Surg 2021; 47:1494-1495. [PMID: 34675163 DOI: 10.1097/j.jcrs.0000000000000802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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David C, Kallel S, Trinh L, Goemaere I, Borderie V, Bouheraoua N. [Intracorneal ring segments in keratoconus management]. J Fr Ophtalmol 2021; 44:882-898. [PMID: 33895029 DOI: 10.1016/j.jfo.2020.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 11/25/2022]
Abstract
Intracorneal ring segments (ICRS), used in the management of keratoconus since the 2000s, have enjoyed significant technological development. Various types of ICRS exist, whose arc length, thickness, and diameter can be chosen according to the desired effect on the spherical equivalent, keratometry and asphericity. Individualized implantation strategies, based on each patient's topographic and tomographic pattern, are constantly evolving. The surgical procedure is standardized, and complications remain very rare. Combined procedures (corneal collagen cross-linking and refractive photokeratectomy±topo-guided, phakic and pseudophakic intraocular lenses) are increasingly used and require a good knowledge of the effect of ICRS alone on the keratoconic cornea. The objective of this review is to summarize clinical practices used in the visual rehabilitation of keratoconic patients using the ICRS+- combined procedures.
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Affiliation(s)
- C David
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - S Kallel
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - L Trinh
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - I Goemaere
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France; Inserm, CNRS, Sorbonne université, institut de la Vision, 17, rue Moreau, 75012 Paris, France
| | - N Bouheraoua
- INSERM-DGOS CIC 1423, CHNO des Quinze-Vingts, IHU ForeSight, 28, rue de Charenton, 75012 Paris, France; Inserm, CNRS, Sorbonne université, institut de la Vision, 17, rue Moreau, 75012 Paris, France.
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Chen D, Lam AK. Reliability and repeatability of the Pentacam on corneal curvatures. Clin Exp Optom 2021; 92:110-8. [DOI: 10.1111/j.1444-0938.2008.00336.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Davie Chen
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China E‐mail:
| | - Andrew Kc Lam
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China E‐mail:
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Garcia-Ferrer FJ, Akpek EK, Amescua G, Farid M, Lin A, Rhee MK, Varu DM, Musch DC, Mah FS, Dunn SP. Corneal Ectasia Preferred Practice Pattern®. Ophthalmology 2019; 126:P170-P215. [DOI: 10.1016/j.ophtha.2018.10.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 10/09/2018] [Indexed: 02/07/2023] Open
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Emre S, Çankaya C, Demirel S, Doganay S. Comparison of Preoperative and Postoperative Anterior Segment Measurements with Pentacam in Horizontal Muscle Surgery. Eur J Ophthalmol 2018; 18:7-12. [DOI: 10.1177/112067210801800102] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose To evaluate the effect of horizontal muscle surgery (recession or recession plus resection) on the anterior chamber parameters in patients after strabismus surgery. Patients and Methods. The Scheimpflug of 18 eyes of 12 patients with horizontal deviations were recorded just before surgery and 1 month after surgery. The power of anterior surface of cornea in horizontal and vertical axis, thinnest corneal thickness, anterior chamber depth, anterior chamber volume, and cornea volume were analyzed. The clinical characteristics of patients, the size of the deviations, the surgical doses, and observed responses to surgery were reviewed. Results There were six male and six female patients with an average age of 11.4 years (range, 4 to 22 years). Mean preoperative deviation was 47.91 PD (range, 20 to 75 PD), eight patients had esotropia with 57.5 PD average deviation (range, 40 to 75 PD), and four patients had exotropia with 28.75 PD average deviation (range, 20 to 35 PD). Of these 18 eyes, 12 eyes had horizontal muscle recession and 6 eyes had recession plus resection surgery. At the end of 1 month, three patients were orthophoric and eight patients had residual deviations varying between 16 and 35 PD. Preoperative and postoperative comparison of the whole study group documented insignificant changes in anterior chamber parameters and in keratometer readings. However, after dividing patients into two groups–recession or recession plus resection group–only one parameter, anterior chamber volume, was significantly reduced in recession plus resection group. Conclusions Patients with strabismus who undergo recession plus resection procedure are prone to change in anterior chamber volume. Study with larger groups and long follow-up is necessary for clearer documentation of alterations at anterior chamber parameters.
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Affiliation(s)
- S. Emre
- Department of Ophthalmology, School of Medicine, Inonu University, Malatya - Turkey
| | - C. Çankaya
- Department of Ophthalmology, School of Medicine, Inonu University, Malatya - Turkey
| | - S. Demirel
- Department of Ophthalmology, School of Medicine, Inonu University, Malatya - Turkey
| | - S. Doganay
- Department of Ophthalmology, School of Medicine, Inonu University, Malatya - Turkey
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Effect of dry eye on Scheimpflug imaging of the cornea and elevation data. Can J Ophthalmol 2017; 52:313-317. [DOI: 10.1016/j.jcjo.2016.11.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 11/01/2016] [Indexed: 11/22/2022]
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Parker JS, van Dijk K, Melles GRJ. Treatment options for advanced keratoconus: A review. Surv Ophthalmol 2015; 60:459-80. [PMID: 26077628 DOI: 10.1016/j.survophthal.2015.02.004] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 02/17/2015] [Accepted: 02/20/2015] [Indexed: 10/23/2022]
Abstract
Traditionally, the mainstay of treatment for advanced keratoconus (KC) has been either penetrating or deep anterior lamellar keratoplasty (PK or DALK, respectively). The success of both operations, however, has been somewhat tempered by potential difficulties and complications, both intraoperatively and postoperatively. These include suture and wound-healing problems, progression of disease in the recipient rim, allograft reaction, and persistent irregular astigmatism. Taken together, these have been the inspiration for an ongoing search for less troublesome therapeutic alternatives. These include ultraviolet crosslinking and intracorneal ring segments, both of which were originally constrained in their indication exclusively to eyes with mild to moderate disease. More recently, Bowman layer transplantation has been introduced for reversing corneal ectasia in eyes with advanced KC, re-enabling comfortable contact lens wear and permitting PK and DALK to be postponed or avoided entirely. We offer a summary of the current and emerging treatment options for advanced KC, aiming to provide the corneal specialist useful information in selecting the optimal therapy for individual patients.
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Affiliation(s)
- Jack S Parker
- Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands; Melles Cornea Clinic, Rotterdam, The Netherlands; UAB Callahan Eye Hospital, Birmingham, Alabama, USA
| | - Korine van Dijk
- Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands; Melles Cornea Clinic, Rotterdam, The Netherlands
| | - Gerrit R J Melles
- Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands; Melles Cornea Clinic, Rotterdam, The Netherlands; Amnitrans EyeBank, Rotterdam, The Netherlands.
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Comprehensive anterior segment normal values generated by rotating Scheimpflug tomography. J Cataract Refract Surg 2013; 39:1707-12. [PMID: 24054966 DOI: 10.1016/j.jcrs.2013.05.042] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 05/14/2013] [Accepted: 05/15/2013] [Indexed: 11/22/2022]
Abstract
PURPOSE To identify normal values for tomographic parameters that are considered useful in screening patients for refractive surgery. SETTING Private center, Albany, New York, USA. DESIGN Database study. METHODS A Pentacam HR Scheimpflug system was used to examine 1 randomly selected eye of patients to determine normal values of 21 parameters considered the most clinically applicable for surgical screening. Normality of data was evaluated using the Kolmogorov-Smirnov test. Statistical analyses were performed using the Student t test to compare means and the 2-paired sample Wilcoxon signed-rank test. Results are displayed in 95.0% and 97.5% confidence intervals (CIs). RESULTS The study evaluated 341 adults. High-end outliers at the 97.5% CI were 46.1 diopters (D) for flat keratometry (K), 47.4 D for steep K, 3.4 D for astigmatism, 3.8 μm for anterior chamber depth, 4 μm for front apical elevation, 5 μm for front elevation at the thinnest point, and 12 μm for front elevation in the central 4.0 mm. Respective posterior elevation values were 7 μm, 13 μm, and 25 μm, with a progression index maximum of 1.53 and mean of 1.19, difference between apical and thinnest pachymetric reading of 7 μm, a maximum K of 48.2 D, and an inferior-superior ratio of 1.44 D. Low-end outliers were a maximum Ambrósio relational thickness of 335 and a mean of 425, minimum pachymetry of 479 μm, thickness at the apex of 481 μm, and central 4.0 mm corneal volume of 6.31 mm(3). CONCLUSION Scheimpflug-derived corneal tomography identified key refractive surgery parameters that may be useful in screening refractive surgical patients.
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Renesto ADC, Campos M. Intrastromal Corneal Ring Segments. Cornea 2011. [DOI: 10.1016/b978-0-323-06387-6.00176-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Piñero DP, Alio JL. Intracorneal ring segments in ectatic corneal disease - a review. Clin Exp Ophthalmol 2010; 38:154-67. [DOI: 10.1111/j.1442-9071.2010.02197.x] [Citation(s) in RCA: 146] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Blum M, Kunert K, Schröder M, Sekundo W. Femtosecond lenticule extraction for the correction of myopia: preliminary 6-month results. Graefes Arch Clin Exp Ophthalmol 2010; 248:1019-27. [DOI: 10.1007/s00417-009-1293-1] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2009] [Revised: 12/18/2009] [Accepted: 12/24/2009] [Indexed: 02/07/2023] Open
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Ertan A, Karacal H. Factors influencing flap and INTACS decentration after femtosecond laser application in normal and keratoconic eyes. J Refract Surg 2008; 24:797-801. [PMID: 18856233 DOI: 10.3928/1081597x-20081001-05] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare accuracy of LASIK flap and INTACS centration following femtosecond laser application in normal and keratoconic eyes. METHODS This is a retrospective case series comprising 133 eyes of 128 patients referred for refractive surgery. All eyes were divided into two groups according to preoperative diagnosis: group 1 (LASIK group) comprised 74 normal eyes of 72 patients undergoing LASIK with a femtosecond laser (IntraLase), and group 2 (INTACS group) consisted of 59 eyes of 39 patients with keratoconus for whom INTACS were implanted using a femtosecond laser (IntraLase). Decentration of the LASIK flap and INTACS was analyzed using Pentacam. RESULTS Temporal decentration was 612.56 +/- 384.24 microm (range: 30 to 2120 microm) in the LASIK group and 788.33 +/- 500.34 microm (range: 30 to 2450 microm) in the INTACS group. A statistically significant difference was noted between the groups in terms of decentration (P < .05). Regression analysis showed that the amount of decentration of the LASIK flap and INTACS correlated with the central corneal thickness in the LASIK group and preoperative sphere and cylinder in the INTACS group, respectively. CONCLUSIONS Decentration with the IntraLase occurred in most cases, especially in keratoconic eyes. The applanation performed for centralization during IntraLase application may flatten and shift the pupil center, and thus cause decentralization of the LASIK flap and INTACS. Central corneal thickness in the LASIK group and preoperative sphere and cylinder in the INTACS group proved to be statistically significant parameters associated with decentration.
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Sekundo W, Kunert K, Russmann C, Gille A, Bissmann W, Stobrawa G, Sticker M, Bischoff M, Blum M. First efficacy and safety study of femtosecond lenticule extraction for the correction of myopia. J Cataract Refract Surg 2008; 34:1513-20. [DOI: 10.1016/j.jcrs.2008.05.033] [Citation(s) in RCA: 221] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2007] [Accepted: 05/29/2008] [Indexed: 11/25/2022]
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Ertan A, Colin J. Intracorneal rings for keratoconus and keratectasia. J Cataract Refract Surg 2007; 33:1303-14. [PMID: 17586391 DOI: 10.1016/j.jcrs.2007.02.048] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2006] [Accepted: 02/15/2007] [Indexed: 10/23/2022]
Abstract
Intrastromal corneal ring segments were designed to achieve refractive adjustment by flattening the cornea. Recently, they have been used to reshape keratoconic corneas to improve uncorrected visual acuity, best corrected visual acuity, and contact lens tolerance and to delay or prevent the need for keratoplasty. Intracorneal ring segments have several distinct and important advantages. New thicknesses and different ring sizes and the use of femtosecond lasers to dissect channels inside the cornea will likely improve the surgical outcomes. This article reviews the latest data published or presented at meetings on the correction of keratoconus and keratectasia by intracorneal ring segments.
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Affiliation(s)
- Aylin Ertan
- Kudret Eye Hospital, Ankara, Turkey, and the Bordeaux University, Bordeaux, France.
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Bibliography. Current world literature. Curr Opin Ophthalmol 2007; 18:342-50. [PMID: 17568213 DOI: 10.1097/icu.0b013e3282887e1e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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